The orthopaedic trauma fellowship application process: An analysis of the applicant experience

Background: Several studies have analyzed the fellowship application process from the perspective of the program director and few have analyzed the application process from the perspective of the applicant. There is no study that analyzes orthopaedic trauma fellowship applicant perspectives on the application process to fellowship. Methods: An anonymous electronic survey was distributed via the Orthopaedic Trauma Association directory to all current orthopaedic trauma surgery fellows and attending physicians one year post-fellowship in the United States who completed fellowship in 2021-2022 and 2022-2023. The survey contained a total of 24 questions: 10 questions regarding demographics and accomplishments, 13 questions regarding interview statistics, preferences and expenses, and a set of questions concerning how applicants formed impressions of programs. Results: 47/180 surgeons (26.11%) completed the survey. 37 (78.7%) were male. There was no associations between sex, USMLE Step 1, Step 2, or AOA status and number of interviews (R<0.20). There was a moderate correlation between the number of applications and number of interviews (R=0.68). Respondents valued faculty interaction (average scoring of 3.91 out of 4) and case volume/complexity (3.83 out of 4) the most. Research was the least valued program factor (2.19 out of 4). The average cost of applying to fellowship was $3331.84. Conclusions: Orthopaedic trauma fellowship applicants value case volume/complexity and faculty interaction the most and least value research. The financial burden of applying to fellowship is significant with most applicants spending over $3000. This study provides insight into factors that applicants value; which may lead to improved applicant satisfaction and reduced financial burden.